The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes resulting in disability. How to treat arthrosis of the knee joint and prevent complications?
What is arthrosis?
About 22% of the world's population suffers from gonarthrosis, with women being more often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint can completely collapse. This leads to impaired function of the musculoskeletal system. Movement is possible only with the help of crutches or the person becomes hostage to a wheelchair.
The knee joint is the second largest after the hip joint and the most complex in structure. It allows you to bend and straighten your leg in different directions, promotes the correct position of the body and coordination in space. It is a strong and stable joint that can support a person's weight. It consists of 3 bones: the femur, tibia and fibula, as well as the patella or knee cap. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually, the cartilage cracks and breaks down. Unprotected bones begin to rub against each other. Pain appears and crunching is heard.
Causes of the disease
It mostly affects the elderly, especially overweight women. As a result of hormonal changes, the cartilage in the knee wears down a lot. Gonarthrosis in varying degrees, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of arthrosis of the knee:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who engage in repetitive physical work. This group also includes athletes, people leading a sedentary lifestyle, people with unfavorable environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological diseases (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be the cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be slight discomfort and pain after prolonged exertion, which disappear after rest. The pain is felt in the morning, with movement it passes after some time. Grade 1 osteoarthritis is rarely diagnosed incidentally during a routine examination.
- Knee pain and stiffness increase. One spares one's leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, a formation is felt, the leg in the knee is not fully extended.
- The pain is constant. The leg does not straighten or bend, and the person has difficulty walking. Partial or complete loss of mobility develops. The cartilage is completely destroyed, the friction between the bones of the joint increases with the formation of osteophytes.
In addition to grade 2 and 3 pain, a crunch is heard in the knee. Fluid and pieces of cartilage can build up in the joint capsule, causing swelling. In the late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnosis
If you have knee pain, you can contact your local doctor who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
In order to understand the causes and treatment of gonarthrosis, a comprehensive diagnosis is necessary:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
The X-ray allows to see the condition of the cartilage and changes in the bones at stage 2 and 3. This is a narrowing of the joint space, osteophytes on the edges of the patella, changes in the periosteum. Arthroscopy gives more detailed information about the meniscus, the synovial membrane and the presence of fluid. This method is also used in the treatment of the knee, to remove parts of cartilage or meniscus.
Treatment of arthrosis of the knee
The therapy is long and sometimes painful. Appeared once, the disease reminds of itself for the rest of your life. The main drugs used for treatment are nonsteroidal anti-inflammatory drugs. Most often, these are drugs based on nonsteroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively cheap, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures in stage 1 include preventive measures related to exercise. Daily exercise, use of a contrast shower, pool 2 times a week and fight against increased body weight are necessary.
Stage 2 requires fixation of the joint - the use of an elastic bandage, bandage or orthosis. NSAIDs in the form of creams and ointments are used to relieve pain. To reduce the rate of destruction of cartilage, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, pain relievers are prescribed.
A hyaluronic acid solution is injected into the joint. It is a substitute for the intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful, it is performed by a doctor after the acute period has subsided. If conservative treatment fails, endoprosthesis is performed.
Together with drug therapy, exercises are prescribed using special simulators and devices (kinesitherapy). Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered by subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are sought after as an alternative to drugs for joint repair. Exercise and massage are indicated. A complex of special exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointments and drugs can restore cartilage. Medicines can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition rapidly worsens. The knee cannot work, serious complications arise:
- deformity of the joint;
- cosmetic defect - distortion of a limb;
- infection of the blood or lymph flow from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed even with normal walking;
- bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not see a doctor on time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent deterioration of the condition and maintain the motor function of the limb.